Active NPI
Circle the City
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Federally Qualified Health Center (FQHC)
- Legal business name
- CIRCLE THE CITY
- Practice address
- 3522 N 3Rd Ave
Phoenix, AZ 85013-3903 - Phone
- (602) 776-9000
- Fax
- (602) 776-9001
- NPI assigned
- Jun 11, 2015
- Last updated
- Oct 10, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. William Ellert, MD
- Title
- Chief Medical Officer
- Phone
- (602) 776-0776
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Federally Qualified Health Center (FQHC) | 261QF0400X | NU | Primary |
Addresses
Primary practice location
3522 N 3Rd Ave
Phoenix, AZ 85013-3903
Mailing address
300 W Clarendon Ave Ste 200
Phoenix, AZ 85013-3422
Phone (602) 776-0776
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 063426 | Medicaid | AZ |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in AZ
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20150609001984 | AZ | Part B Supplier - Clinic/Group Practice | 3971824442 |
Receives reassigned benefits from 68 practitioners 8 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Phoenix, AZ |
| O20150813012502 | AZ | Part A Provider - Federally Qualified Health Center (FQHC) | 3971824442 |
2 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Phoenix, AZ |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1679954184. Details of each certification follow.
Federally qualified health center certification: CCN 031926
- Legal name
- CIRCLE THE CITY
- Doing business as
- PARSONS FAMILY HEALTH CENTER AT CIRCLE THE CITY
- Certification status
- Active
- Provider type (POS)
- Federally qualified health center
- Participating since
- Aug 4, 2015
- Last certification
- Aug 4, 2015
- Ownership / control type
- Non-profit – church related
- Organization structure
- Corporation
- Incorporated
- Mar 11, 2008 in AZ
- Enrollment address
- 3522 N 3Rd Ave
Phoenix, AZ 85013-3903
Other NPIs on the same Medicare enrollment 9
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Circle the City Medical Respite Center, Downtown Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1346755295
O20150609001984
-
dba Circle the City Family Health Center - UMOM Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1447765474
O20150609001984
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1487033247
O20150609001984, O20150813012502
-
dba Circle the City Family Health Center, After Hours Clinic - LDRC
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1497260426
O20150609001984
-
dba Circle the City After Hours Clinic - CASS
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1548775497
O20150609001984
-
dba Circle the City Family Health Center, Downtown Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1548775570
O20150609001984
-
dba Circle the City Mobile Clinic II
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1952948804
O20150813012502
National Provider Directory
National Provider Directory- Tax ID family
- Circle the City
Other organizations with this tax ID 12
Organizations that report the same tax identification number in the National Provider Directory.
-
dba Circle the City Family Health Center-HOPESS
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1144106196
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1164055596
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1386504751
-
dba Circle the City Family Health Center - UMOM Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1447765474
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1457211765
-
dba Circle the City Family Health Center, Downtown Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1548775570
-
dba Parsons Family Health Center
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1619763729
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1932588795
-
dba Circle the City Mobile Clinic II
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1952948804
Ownership & related parties
All disclosed owners & managing parties 17
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| James T Nathan | Corporate Director | Mar 23, 2015 | |
| Kelli Kathleen Smith | Corporate Officer | Jan 1, 2022 | |
| Roy Pringle | Corporate Director | Oct 24, 2016 | |
| Adele Marie O Sullivan | Corporate Director | Jul 30, 2018 | |
| Michael Zenobi | Corporate Officer | Dec 1, 2020 | 33% |
| W-2 Managing Employee | Dec 1, 2020 | 33% | |
| Operational/Managerial Control | Dec 1, 2020 | 33% | |
| Circle the City | 5% Or Greater Direct Ownership Interest | Jun 12, 2015 | 100% |
| Ryan Andrew Odgers | Corporate Officer | Jan 1, 2022 | |
| Thomas Betlach | Corporate Director | Jan 1, 2022 | |
| Kim Despres | Corporate Officer | Dec 1, 2020 | 33% |
| W-2 Managing Employee | Dec 1, 2020 | 33% | |
| Operational/Managerial Control | Dec 1, 2020 | 33% | |
| Clayton Foster | Corporate Director | Jan 1, 2022 | |
| Marc L Leib | Corporate Director | Oct 24, 2016 | |
| Kathy Stein | Corporate Director | May 22, 2017 | |
| Petrona Zickgraf | W-2 Managing Employee | Dec 1, 2020 | 23% |
| Lori Ann McClelland | Corporate Director | Sep 27, 2010 | |
| Danielle Millard | Corporate Officer | Jan 1, 2022 | |
| Jaxinta Shaffer | Corporate Officer | Jan 1, 2022 | |
| Marion K. Kelly | Corporate Director | Oct 24, 2016 |
Owners & managing parties with NPI records 8
Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.
-
dba Circle the City Pharmacy
- Community/Retail Pharmacy
- Phoenix, AZ
- NPI 1144093972
5% Or Greater Direct Ownership Interest
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1346588316
5% Or Greater Direct Ownership Interest
-
dba Circle the City Medical Respite Center, Downtown Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1346755295
5% Or Greater Direct Ownership Interest
-
dba Circle the City Family Health Center - UMOM Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1447765474
5% Or Greater Direct Ownership Interest
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1487033247
5% Or Greater Direct Ownership Interest
-
dba Circle the City Family Health Center, Downtown Campus
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1548775570
5% Or Greater Direct Ownership Interest
-
- Federally Qualified Health Center (FQHC)
- Phoenix, AZ
- NPI 1932588795
5% Or Greater Direct Ownership Interest
-
- Orthopaedic Hand Surgery Physician
- Phoenix, AZ
- NPI 1891014049
Corporate Officer
Practitioners & affiliated clinicians
Practitioners 9
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1952506867
-
- Internal Medicine Physician
- Phoenix, AZ
- NPI 1841554920
-
- Physician Assistant
- Phoenix, AZ
- NPI 1679367288
-
- Physician Assistant
- Phoenix, AZ
- NPI 1942386990
-
- Hospice and Palliative Medicine (Emergency Medicine) Physician
- Mesa, AZ
- NPI 1104889294
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1780654715
-
- Physician Assistant
- Scottsdale, AZ
- NPI 1174777049
-
- Family Medicine Physician
- Phoenix, AZ
- NPI 1023046430
-
- Family Nurse Practitioner
- Phoenix, AZ
- NPI 1497089403
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433980800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1728518400000",
"number": "1679954184",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "300 W CLARENDON AVE STE 200",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133422",
"telephone_number": "602-776-0776",
"fax_number": "602-705-0567"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3522 N 3RD AVE",
"city": "PHOENIX",
"state": "AZ",
"postal_code": "850133903",
"telephone_number": "602-776-9000",
"fax_number": "602-776-9001"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "CIRCLE THE CITY",
"organizational_subpart": "NO",
"enumeration_date": "2015-06-11",
"last_updated": "2024-10-10",
"certification_date": "2024-10-10",
"status": "A",
"authorized_official_last_name": "ELLERT",
"authorized_official_first_name": "WILLIAM",
"authorized_official_title_or_position": "CHIEF MEDICAL OFFICER",
"authorized_official_telephone_number": "602-776-0776",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "261QF0400X",
"taxonomy_group": "",
"desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "063426",
"state": "AZ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Phoenix, AZ
- Circle the City
- Circle the City (Circle the City Family Health Center, After Hours Clinic - LDRC)
- Circle the City (Circle the City After Hours Clinic - CASS)
- Circle the City (Circle the City Family Health Center, Downtown Campus)
- Circle the City (Parsons Family Health Center)
- Circle the City (Circle the City Provider in Triage - Brian Garcia Welcome Center)
- Circle the City
- Circle the City (Circle the City Mobile Clinic II)
- Circle the City Behavioral Health, LLC
- Robert L Cirillo Jr., M.D., M.B.A.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.